Sanitation in Panama

by William Crawford Gorgas

Yellow fever has appeared in epidemic form several times in Italy, but has never extended further east. Leghorn is the most eastern point to which yellow fever has ever reached. There in 1804 a severe epidemic occurred in which some two thousand persons died.

On the west coast of Africa epidemics have occurred as far south as St. Paul de Loanda. The island of Ascension, about the same latitude as St. Paul but in the mid-Atlantic, has suffered very severely. In 1823, the British sloop Bann brought yellow fever from Sierra Leon to Ascension. Ninety-nine cases occurred on the Bann, with thirty-four deaths, and on the island itself twenty-eight cases occurred with fifteen deaths.

Yellow fever has been epidemic on the east coast of South America as far south as Montevideo, and on the west coast as far south as Valparaiso, and on this same coast as far north as Guaymas, Mexico.

The epidemic area of yellow fever has been very much more extensive than the endemic area. This epidemic area would then be bounded by a line commencing on the north at Quebec, Canada, extending east to Swansea, Wales; from Swansea south to St. Nazaire, France; from St. Nazaire southeast to Leghorn, Italy; from Leghorn south to Loanda, on the west coast of Africa; from Loanda west across the Atlantic to the island of Ascension; from Ascension still west across the Atlantic to Montevideo; from Montevideo still west across South America to Valparaiso, Chili; from Valparaiso northwest to Guaymas, and from Guaymas northeast back to Quebec.

By lines of latitude and longitude the epidemic area would be bounded on the north by the forty-fifth degree, north latitude; on the south by the thirty-fifth degree, south latitude; on the east by the tenth degree, east from Greenwich, and on the west by the one hundred and tenth degree, west from Greenwich.

In point of area its period of greatest extent was during the first half of the nineteenth century. Since the middle of the nineteenth century its area has been decreasing rapidly, until at the present time this disease is confined to a half dozen centers in South America.

Within the epidemic area the loss of human life from this disease has been very great, the United States and Spain, being the most populous countries affected.

South America lies generally well east of North America, and its northern coast is about opposite the southern part of North America, so that the neck of land which connects the two runs east and west and is known as the Isthmus of Panama. Most of this isthmus is embraced in the present Republic of Panama.

Columbus was the first white man to visit Panama. On his third expedition he entered the Bay of Bocas del Toro, and spent some time there. On this same expedition he also visited Limon Bay, into which the northern end of the Panama Canal at present empties. He also visited Porto Bello, which afterwards became rich, famous, and populous, and which is located on the northern extremity of the royal paved highway running north from the old city of Panama. He left more than one hundred men under his brother, Diego, at Belen, some fifty miles west of the present town of Colon. After several years of sickness, hardships and deprivations, this colony was finally destroyed by the Indians. Spain afterwards ennobled Columbus’ grandson, Luis, under the title of Duke of Veragua, and granted to him a large tract of land in the neighborhood of this old colony, to which was given the name “Dukedom of Veragua.” One of the provinces of the Republic of Panama which covers about the same area as did the tract referred to, is known as the Province of Veragua. The old royal highway just referred to, running between Panama and Porto Bello, lies from five to fifteen miles east of the Canal. Columbus’ third voyage was made in 1498. A few years later, Balboa, with a party of Spanish adventurers, under the authority of the Captain-General from Santo Domingo, arrived in the eastern part of Panama and made permanent settlements, at first on the north coast, and discovered the Pacific.

A few years later, in 1519, the city of old Panama was founded. Balboa was the best type of the Spanish conquistador. He was brave, hardy and determined, qualities very common to the early Spanish adventurers, but Balboa was more able and had much broader views of government and colonization than either Pizarro or Cortez. He was displaced as governor of Panama by Pedrarias, a man inferior to him in every respect. Balboa was beheaded by Pedrarias in 1517. He had heard of the Inca empire to the south, and was getting together a fleet on the south coast with the intention of invading this empire. Pedrarias became jealous of his power, and feared he was getting together a force for the purpose of overthrowing his government. As far as historical data show, there was no reason for this jealousy.